Toward a more comprehensive understanding of organizational influences on implementation: the organization theory for implementation science framework.

Autor:	Birken SA; Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States., Wagi CR; Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States., Peluso AG; Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States., Kegler MC; Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA, United States., Baloh J; College of Public Health, Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, United States., Adsul P; Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States.; Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, United States., Fernandez ME; Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States., Masud M; Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States., Huang TT; Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States., Lee M; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States., Wangen M; UNC Center for Health Promotion and Disease Prevention, University of North Carolina Chapel Hill, Chapel Hill, NC, United States., Nilsen P; Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden., Bender M; Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States., Choy-Brown M; College of Education and Human Development, School of Social Work, University of Minnesota, St. Paul, MN, United States., Ryan G; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States., Randazzo A; Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States., Ko LK; Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in health services [Front Health Serv] 2023 Aug 31; Vol. 3, pp. 1142598. Date of Electronic Publication: 2023 Aug 31 (Print Publication: 2023).
DOI:	10.3389/frhs.2023.1142598
Abstrakt:	Introduction: Implementation is influenced by factors beyond individual clinical settings. Nevertheless, implementation research often focuses on factors related to individual providers and practices, potentially due to limitations of available frameworks. Extant frameworks do not adequately capture the myriad organizational influences on implementation. Organization theories capture diverse organizational influences but remain underused in implementation science. To advance their use among implementation scientists, we distilled 70 constructs from nine organization theories identified in our previous work into theoretical domains in the Organization Theory for Implementation Science (OTIS) framework. Methods: The process of distilling organization theory constructs into domains involved concept mapping and iterative consensus-building. First, we recruited organization and implementation scientists to participate in an online concept mapping exercise in which they sorted organization theory constructs into domains representing similar theoretical concepts. Multidimensional scaling and hierarchical cluster analyses were used to produce visual representations (clusters) of the relationships among constructs in concept maps. Second, to interpret concept maps, we engaged members of the Cancer Prevention and Control Research Network (CPCRN) OTIS workgroup in consensus-building discussions. Results: Twenty-four experts participated in concept mapping. Based on resulting construct groupings' coherence, OTIS workgroup members selected the 10-cluster solution (from options of 7-13 clusters) and then reorganized clusters in consensus-building discussions to increase coherence. This process yielded six final OTIS domains: organizational characteristics (e.g., size; age); governance and operations (e.g., organizational and social subsystems); tasks and processes (e.g., technology cycles; excess capacity); knowledge and learning (e.g., tacit knowledge; sense making); characteristics of a population of organizations (e.g., isomorphism; selection pressure); and interorganizational relationships (e.g., dominance; interdependence). Discussion: Organizational influences on implementation are poorly understood, in part due to the limitations of extant frameworks. To improve understanding of organizational influences on implementation, we distilled 70 constructs from nine organization theories into six domains. Applications of the OTIS framework will enhance understanding of organizational influences on implementation, promote theory-driven strategies for organizational change, improve understanding of mechanisms underlying relationships between OTIS constructs and implementation, and allow for framework refinement. Next steps include testing the OTIS framework in implementation research and adapting it for use among policymakers and practitioners. Competing Interests: The authors PN, TH, MEF, and PA declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Birken, Wagi, Peluso, Kegler, Baloh, Adsul, Fernandez, Masud, Huang, Lee, Wangen, Nilsen, Bender, Choy-Brown, Ryan, Randazzo and Ko.)
Databáze:	MEDLINE
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